23711 80TH CT W.PDF111111111111
7238
23711 80TH CT W
ADDRESS:-,z;23 -7 / / - 9- 5;Fo-/-q o4aA --4A—*
TAX ACCOUNTIPARCEL, NUMEBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
.q
cfcf—
CRITICAL AREAS: rl:R DETERMINATION: El Conditional Waiver R Study Requi5<Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT:— BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DA
OTHER:
LATEMPTS'PsTonns\Street File Checklist.doc
4
C . 199
City of Edmonds
SIDE SEWER PERMIT,
PERMIT NO. 9919
PERMIT -EXPIRES O/W),
t
LIZ, LID ; #
Address of Constructionrg3Z&
Property Tax Account Parcel No.
Attach copies of all access and utility easements . Verified and Approved b
Owner and/or Con
tractor: - Wk 496
Contractor License V a Buildin g Permit
__z
UKingle Family
Multi -Family (No. of Units
F� Commercial'(N6. of Un its
F] Public
Invasion'into City *Right -of Way: El Yes - MlNo
*RW Construction Permit #
Cross other'"Private Pr . operty: El Yes 1�6
**Attach legal description and copy of recorded easement.
Owner oF'Eo-ntractor si a re and acknowledgement statement:
t.1 certify that I have read the City's public handout'entitled
.S
4-
ide Sewer Specifications, and shall comply with all City requirements outlined therein.
Date
W. CALL'DIAL-A-DIG'.(1-800-424��5555) BEFORE ANY EXCAVATION W
FOR INSPECTION'CALL 425-771-0220 extension OZ2
24 HOUR NOTICE REOUTRED FOR ALL -INSPECTION REQUESTS
Ir
t� PERMIT MUST BE POSTED ON JOB SITE T�
White Copy: File Green Copy: Inspector Buff Copy: Applic ant
L;temp;bldg;forms;ssperTnitjlg4/00
--dog x
23709.80th Court 23711 80th Court
Lot # 24 Lot # 25
Garage Permit # 9920 Permit # 9919
Covered Porch
Parking
18'
ABS
3.5'-
4 4" C/O 2'
PVC .5' C/o
F 4'deep
4" PVC 6" PVC
6"C/0 18.5' ABS
Pv to
" C/O
PVC
4
4' PVC
/0
C
WYE Connect to main
detailed in plat dwgs.
2' Deep
Pdvate Ddvewr�
4.5'Deep
Connect to main
detailed in plat dwgs.
ED* CITY OF EDMONDS SIDE SEWER AS- BUILT
0
ADDRESS 23709 80th Court SW HOMEOWNER
23711 80th Court SW Viking Properties Inc.
CONTRACTOR SCALE
Viking Properties Inc. NTS
DATE DRAWN. PERMIT 99.19
&t 1890 6/16/2005 BY Nima M.Moghaddam NO.
ED*
0
VVI I n 1 r-N L r-%
3' DEEP
80TH COURT SW
CITY OF EDMONDS WATERLINE AS -BUILT
ADDRESS HOMEOWNER
23711 80TH COURT SW VIKING PROP.
CONTRACTOR SCALE
CAJUN EXC. NTS
DATE DRAWN WATERLINE
7/26/05 -By 1. ABILA NO, 2004-1021
0
, EDIr _
vvi in lmt_k�lr_rllu
3' DEEP
80TH COURT SW
CITY OF EDMONDS WATERLINE AS -BUILT
ADDRESS HOMEOWNER
.23711 80TH COURT SW VIKING PROP.
CONTRACTOR SCALE
CAJUN EXC. NTS
DATE DRAWN WATERLINE
7/26/05 BY 1. ABILA NO, 2004-1021
0
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist is to enable City staff to
deterrnine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
i2lec-�1
1 3A
Date Receivecl:.51 i V 1 cq_-�2
City Receipt#: 1 `)-4 (a ?> 0
Critical Areas File #: ca'-:3--002-0
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant: 4-11-03
A property owner, or his/her authorized representative,
must fill out the checklist, sign and -date it� and submit it
to the City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application'. .
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. in
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
77he undersigned applican� and his/her/its heirs,.and assigns, in consideration on the processing of the application agrees
to release, inderrinify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attomey's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fumished by the applicant, his/her/its; agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file t is plicabon_9affie behal e owner as listed below.
to 4filet -:s
SIGNATURE OF APPLIcANT/AG DATE
jo
Property Owner's Author" ati
By my signature, I cer* I C authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for e public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OVINER —DATE
PLEASE PRINT CLEARLY
Owner/Applicant:
" 0 a W(940 r_1
14ame 1
-Z 5 C -3 Z
Street Address
,�;6waW5
city State zip
Telephone:
Email address (optional):
AppHcant Representative:
Name
/ -70 A&I-;-
Street Address
. Zf-41&r qT-
city State zip
Telephone: 1Y 7-572- 22�2-
Email Address (optional): o4p-bt
V W
Critical Anas Chocklist.doc/3.19.2001
0
0
-C. 157
City of Edmonds
Development Services Department
Planning Division
Phone: '425'771.0220
Fax: 425.771.0221
Ile Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received: I c5t7
City Receipt#:_ I-ka,3 0
Critical Areas File #: -7-00-3 -CO02-1
Critical Areas Checklist Fee: $4 .00
Date Mailed to Applicant 4�446-3 _
A property owner, or his/her authorized representative,
must fill out the checklist sign and date it, and submit it
to the City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the. s igned copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indernnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from anyaction or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fumished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file t p icati n
th ized o file he behal e owner as listed below.
or t t s
SIGNATURE oF APPLicANT/AG DATE 't>
r
Property Owner's Author* atio
By my signature, I cert*ify I e authorrized tUhe above Applicant/Agent to apply for the subject land use application,
and grant my permission for e public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER
Owner/Appficant:
I —
" 0 Lv W) 04$ Z-J
14ame I
-2 � C -3 Z F
Street Add=s
la;6wOW5
city State zip
Telephone:
Email address (optional):
DATE
Applicant Representative:
IL">/T
Name
/ -7z-,2 / Alc;c-2 Tr— Ag;-
Street Address
city State zip
Telephone: qZ5- 7-572- - 22 12-
Email Address (optional): joht,,y ok#-bt
0itical Ams Checklist.dor/3.191001
City of Edmonds
Development Services Department
Planning Division
Phone: '425'771.0220
Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose'of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The inforniation
needed to complete the Checklist should be easily
available from. observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received: V I (D�:7
City Receipt#: 7-1 V�SO
Critical Areas File#: — -0 0 .2
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant , ::K�- I
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the,signed copy
of this form to assist City staff in firiding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site. .
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, inderrinify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file *,s plication o 4e behal e owner as listed below.
SiGNATum oF APPLicANT/AG DATE
Property Owner's Author' atiai;4:
ba,�
By my signature, I cer* I authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for e public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER DAM
PLEASE PRINT CLEARLY
Owner/AppHcant , &r-P4(A V C)
0A1
Name
Stred Address
4;6waW5
city State zip
Telephone: L/"�61
Email address (optional):
Applicant Representadve:
Name
1-701 HL;,dir- Aa-;:-
Street Address
city State zip
Telephone:
Email Address (optional): _Ioht-,yj 4.--b,
U W
0itical Amas Checkfist.dorJ3.19.2001
WILE NO.
Critical Areas Checklist
------------------------------------- -------------------
Site Information (soil s/topography/hydrology/vegetation)
7W
W
1. Site Address/Location: 7LA -3141 - - ------------
2. Property Tax Account Number:
3. Approximate Site Size (acres or squa, re feet):
4. Is this site currently developed? —Zyes; no.
If yes; how is site developed? Y-easer sI7:� oN -s,6- Ax ro*a Ae
j��
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of
I 0-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth-
7. Site contains areas of seasonal standing water:
d6jZE— Approx. Depth:
What �eason(s) of the year? 1/
8. Site is in the floodway Aja floodplain Ale) of a water course..
9. Site contains a creek or an area where water flows across the gro - unds surface? Flows are -year. -
round? AVM5"— — Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs mi xed
urban landscaped (lawn,shrubs etc) w47W rA&r--- .7V
11. Obvious wetland is present on site:
----- — ----------
- ------------------------- ---------- For City Staff Use Only ------------- — -- --- --
..:.site 6
I is zonedlem-::-�s A
.. ..... .. . .... . ..... . .
.2. SCS mapped soil type(s)?:::t
:3. Wetlan.d inventory or. C.A. map indicates w'etland present on site'?
4. Critical Areas inventory or C.A. map indicates Critical Area on site,)
'Site 'Within desl�gna*tedearth subsidence landslide hazard area?
'site designated on the Environmentally Sensitive Areas Map. Mb
CONDIIIONALWAIV-Elk:
111,610 -
D Tte -
u-chk.doc: Rev 1010'
0
City of Edmonds
RECSIVED
JAN 0 6 1999
COMMUNIN SERVICES
'CRITICAL AREAS.CHECKLIST
The Critical Areas Checklist contained on this form is
to be filled out by any person preparing a
Development Permit Application for the City of
Edmonds prior to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, 'or
may be, present on the subject property. The
information needed to complete the Checklist should
be easily available from ;observations of the site or
data available at City Hall (Critical Areas inventories,
maps, or soil surveys).
An applicant, or his/her representative, must fill out
the checklist, sign and date it, and submit it to the
City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps, necessary to c omplete,a,development
permit application.
Please submit a vicinity map along with the signed
copy of this form to assist City staff,in finding and
locating the specific piece of property described on
this form. In addition, the applicant shall include
other pertinent information (e.g., site plan'. -topography
map, etc.) or studies in conjunction with this Checklist
to assist staff in completing their preliminary
assessment of the site
-A
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
O,si,ner/Applicant.' Applicant Representative:
.1—oAlu AL*6a�Nra;Ze�9
Name / . . �_/ Name
23a,�17
Street Address
Street Address
Allib-S �Vlju�
City State Zip city State Zip
Telephone Telephone
Si' naf6e
9, Signature
Date
(over)
ALL EXPOSED SURFACES To
BE COVERED WITHIN 2 DAYS
3 ID-1
0 SINGL 10
E FAMILY
FAMI�,Y, z .66- 1 C�
11 in R�SIDENCE
ENCE V)
237Q OURT W.
COURT W.
OWN ER/CONTRACTOR 1S R
ESPQ ISI
FOR EROSION CONTRO
D
r
W
1-4,94-
9-21'37" W
AN /8
V-00 r,1 A V
C�6
f4.92f
36.50
C C
B
MAINTAIN PLAT INS�ALLED ER�SI04-b6'�-qOL 25
SINGLE FAMILY
FAMILY ccj
66 RESIDENCE
ENCE 23711 80th COURT W.
COURT W.
A— 6-x1 0-,p-QE#q D
D 4.�5'
109 Z 113 7— w
042 1�34--
-W 0')
2371 OURT W.
7#,3
C
26
SINGLE FAMIL
-AMILY /Z Y
RESIDENCE
'NCF
A t
f6 7
0� 7L&/
ACCEPTABLE �IGHTLINE JUL
13- MATERIAL N
PER" COU
SDR 35 COUNT'r.
SCH 40
SCALE 1"=20'
OWN ER/CON TRACTOR N - 12
VIKING PROPERTIES, INC. F810 HANCORv
P.O. BOX 1034 0' 10' 20'
,,
LYNNWOOD, WASHINGTON 98046 WATER a SEWER
PHONE : 425-670-2711 PLOT PLAN
C INSPECT..-!ojqS REOD. FOR (�Os
BENCH MARK MU 425-771-0220 nj
THE PROJECT BENCH MARK IS THE CONCRETE �26
MONUMENT IN CASE LOCATED AT THE LOT VIKING HEIGH TS
CENTERLINE OF 238TH STREET S.W. AT
APPROXIMATELY THE MIDPOINT OF THE I N SE1/4, SECTION 31, T.27N., R.4E., W.M.
PROPERTY. CITY OF EDMONDS
ELEVATION : 200-00 SNOHOMISH COUNTY, WASHINGTON
DATUM : ASSUMED
APPROVED AS NOTED
BY EIINGNEERING
Date:
=11111VIIIIIIIIIN Lovell —Sauerland & Associates, Inc.
Eugmem/Surveyers/Plamers/Development Consultants
0 mil: inf.0lmgmeemg.own -. web: lsmgmee�..
19W 33rd Avenue W.. Suite 200 Lynnwood. TA 98036 - (425)775-1591 - (425)672-7998 fax
7
DRAWN FU NO.
JTT 3.6.03 1"= 270'4656-0-04
JTT I.' I — I
9
� MR-7
�-O
!ZNi
lu LL BE LART
WGROUND CDVER
�,ER LEGEND (TYP)
V
im
I HIGAMBURKHOLDER
ASSOCIATES, LLC
LAND USE PLA14MING I CIVIL ENGINSERINO
1721 Howitt Avgmm m Suite 401 111 Evwetlk. WA 9a20l
phme (425)252-2M fc. (425)252-9551
0 Z �-1 � \ %b�� aj
ALL EXPOSED SURFACES TO
BE COVERED WITHIN 2 DAYS
3 0
FAMILY z
ENCE!
FOR EROSION
W.
__C
MAINTAIN PLAT INSTA�LED ERO
FAMILY -c
C
ENCE
COURT W.
CYJ
W -- I . li, 1 0)
- -t�43
-AMILY
C,
8.?
-0-1 SINGL FAMILY
R�SIDENCE
23704 OURT W.
Eavts
D
U)
<
C
B
.25
SINGLE, FAMILY
RESIDENCE
23711 80th COURT W.
A_ 6-.10- pCEj_q_ _ D-��
26
SINGLE FAMILY
RESIDENCE
T-4.94;
f4.921
C�
u-i
0
10( 17'
till"
'7f /- � )-�- y - 5 -7 C jvf�o
TA LE TIGHTLINE 62004
ACCEF"' 51
13, MATERIAL N COV
D SDR 35 PE�Mj Co TER
SCH 40 SCALE : 1"=20'
OWNER /CON TR ACTORN - 12 i .
\AKING PROPERTIES, INC. F810 HANCOR w 4 � C,-,
P.O. BOX 1034 0' 10' 20' 4 lk.
LYNNWOOD, WASHINGTON 98046 I0h
PHONE : 425-670-2711 NATER & SEWER
INSPECTIONS REQ'D. PLOT PLAN
Lod
BENCH MARK CALL 425-771-0220 EXT. 1326 FOR
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE LOT 25., VIKING HDGHTAf0;"'
CENTERLINE OF 238TH STREET S.W. AT
APPROXIMATELY THE MIDPOINT OF THE IN SE1/4, SECTION 31, T.27N., R.4E., W.M.
PROPERTY. CITY OF EDMONDS
ELEVATION : 200.00 SNOHOMISH COUNTY, WASHINGTON
DATUM : ASSUMED
APPROVED AS NOTED
BY ENGINEERI
Ir/Y7 el�
D a t e:
�Nm% Lovell—Sauerland & Associates, Inc.
&w--/S--y---/pl-mm/Development ConsWtants
L�m 0 md-. info#b&m&eeriz tg-com - web: baenginft�.com
19W 33rd lveuue T.. Suite.200 LVM.wOod. TA 9M - (425)775-1591 - (425)672-7M fax
DnTN F.B. S=
JTT I aM= I D= ME NO..
JTT 3.6.03 1"= 20' 4656-0-04
LlU K ASSOCIqTES 4262746 P.01
%ph /A SIL11)
DAILY FIELD REPORT
LAU & ASSOCIA'FES, INC.
ElIgACC611E., Vnoillci;611." rjeo)()P� & Earth �Cittloc
192 13 Ke n lak.- P lacc N 13
Kennion', Wa.511ingl[011 98028
Phone: (425) 481-9134 rax: (425) 486-2746
i nts 25 1,hrouah 26 - Sunrise Ridge 60xx - 238th '
eneral on ra
Ted Colema
4AO85
I
J. Liu
of 1
8
Ti�,,e GnM—W
-Ca—te
- D a Y 0 ec;l"
3:30P
4/18120.05
M oil.
Trm—e'-OTT t—e
We a t n a i
3:55P
Parity Cloudy—
kj�' .
jjtejrRr5-CFja'-gi�r-
1.2.5
QWn'.
Ednionds
Vi�ino, Pr r-AeS -1�-,—__]Reoeived C�ecVed By
�2_ �2 Earthivork contractor _,9upt.
T.'Farinw0iK COntraC(Or
Ca"un 5xcav
At the request by Ted Coleman with Viking PiloPertie-S, I come on site to verify the footing bearingsolls for the
tiousps to be built on the subject lots. At the time of my site visit the footing trenches on these lots have all bePn
e,xr,avated Out down to the footi.119 level, No groundwater seepage or stand"rig water is observed witliiri thP SUbjeCt
jols. Some loose oisturbed soils have fallen into the footing trenches, and in places a thin 13ye,, of soils over the
bottorn of the footing t(enches is disturbed by the scraping of the backhoe bucket. especi,?4 the southern half of
i-ot 26,
Tho� footing trenches are cut (jown about 2 feet below existing grade into brown to light-browin strLICIU-'al fill Of Si1tV
fine sand with a trace of gravel. A steei T-bar manually pushed into the footing bearing soils can penetrate no more
than 4 to 5 inct,.es into the undisturbed footing bearing soils, indicating the soils are medium -dense to densc-.
*1 ho loose th.1n layer of soils disturbed by backhoe bucket should be compacted to �4 non-y�,elding state with a
1 ,is are followed, It is my opinion that the footin g
v!irato,'YmLicilaiiicalcorTipacior It the lbove recornmendatio
b��aring soils will be able to render an allowable bearing capacity of at leasi 3,000 psf
C1 Contill"14:"!
COI)t I
7015V to: N
',) Ted ColemanNiking Properties 2) e
3) 4)
DATE RECEIVEDU/:�O/,W
IT
FPERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
ZONE
NUMBE��,��
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT#
ADDRESS
.7
NAME/NAME.VUSINESS
FCAT NAME/S
Y f KfmZ(
IV69IOT0.
LOT NO.
L�D NO.
L D FEE $
xt
I Yin
15 MAILING ADDR
PUBLIC RI&J OF WA01jlFt OFFICIAL STREET MAP
TIESCP Approved
RW Perritit Required
I P D J%)( loaq
EXISTING se- PROPOSED
Street Use Pennit Req'd
Inspection Required
Sidewalk Required
Underground
ITY ZIP
TELEPHONE
> L 70 d 7 1 t
REQUIRED DEDICATION FT
1 wiring required
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV� REQUIRED
YES�t NO 13
A6DRESS
REMARKS
x
0
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE
1044 4 �_VWI iWaVAU ftVkA, 14a-UI9
TELEPHONE
i N-WC1"
WCITY
k4eN
1174,-'SeY-7j:�-6-W
I NAME. , I
ICBL # I 1��j
- - - '0 �._ - - . A
I F-1 I
REVIEWED BY DATE
ADDRESS
j�tX
:-FIRE REVIEWED BY < DATE
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CITY
U\ Zip
TELEPHONE
VARIANCE OR CU
SHORELINE OR ADB #f.*I,-'
INSPECTION
J�REO'D
PYES - AO
BOND
POSTED
$
z
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CL
8TAd LICENSE NUMBER EXPIRATION DAT C C By
BY
I '.t _ , I � I
SEPA REVIEW
COMPLETE EXEMPT-.-
EXP
SIGN,AREAV
ALLOWED PROPOSED
HEIGHT
,,,ALLOWED PROPOSED
?
PROPERTY TAX ACCOUNT, PARCEONO.
NEW RE�IDENTAL-' PLUi�13INd/MECH'
COMPLIANCE OR
ADDITION !'COMMERCIAL �.CHANGE O-F USE
REMODEL MULTIFAMILY r I -
S GN
E
0 REPAIR CYDS Er) - X _� FT3
1:1 DEMOLISH 0 TANK OTHER,
VGARAGE RETAINING WALL o FRE SPRINKLER
CARPORT 0.ROCKERY ME ALARM
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LOT, AREQ&kPLANNING RE\nEWEbldii DATE
144
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AtYPE OF USE, BU4DfkS OR A IVqY)
EXPLAIN:
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TYPE,OF LICTION 0
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OCCUPANTfi.,�
GROUP
NUMBER
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STORIES C;Q
NUMBER.OF -
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UNIT
CRITICAL
AREAS
N U M 8 E R'�
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OCCUPANT
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DESCRIBE WORK TO BE DONE
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Description
Description
FEE
cl - lr�)bl - nal C�o
Plan Check
State
Surcharge
T So! �RCE
7ING %
't.,,LOT�SLOPE %
�"BuildlngRermit
;O;V City
Surcharge
PLAN CHECK NO:
VfSTEIP��A 1)
Ing-
lumb"
Base
Fee
6 L
THIS PERMIT AUTHORIZES ONLY THE WORK I _OVER-S VUA
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
a DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC .) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPUCATION: 180 DAYS
IL PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Mechanical
lg:2�2
Grading
Engr. Review
Engr. Inspection
APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
PlanChk.Deposft
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND
W ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMFE ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
X1
Fire Inspection
Receipt #
74 -71
Landscapelnsp.
Total Amt. Due
'6
Recording Fee
Receipt # r
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S C0>91191ATION INSURANCE AND RCW 18.27.
CALL
FOR INSPECTION
This applicaflon is not a permit until signed by the
Building Otliciall or his/her Deputy: and Fees are paid. and
receipt Is acknowledged In space provided.
FI LS SG RE DATE
(425)
SIG UR�' VWN1 ENT)
DCSIGNED
7/f,
. 01i n4
771-0220
EXT 1333
R ED BY, bATE
1 %=�
ATTENTION
ITIS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADEANDAPPROVALORACERTIFICATE OF OCCU- ORIGINAL -FILE YELLOW- I;1SP(CTOR
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110. PINK -OWNER GOLD -ASSESSOR
09/03 r%r%g-d%^ 1.1 A r%r% %10%1 1 A r%r-' RM A A